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Washington rates for HCPCS B4152

Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit

Facilitymedian $0 · 10th–90th $0–$10%20%10th90th$0Professionalmedian $0 · 10th–90th $0–$20%20%10th90th$0$0.2$1.0$5.0$20.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.66 / $1.66 / $1.66
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.41 / $0.50 / $1.00
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.33 / $0.33 / $0.49
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.24 / $0.24 / $0.24
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $75.86
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.38 / $0.38 / $0.56
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.40 / $0.56 / $0.79
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.37 / $0.37 / $0.37
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.41 / $0.50 / $1.07
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.33 / $0.33 / $0.33
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.31 / $0.31 / $0.39
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.42 / $0.76 / $1.20
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.33 / $0.33 / $0.59